Posts in:January, 2018

Social Security Disability for Heart Conditions

Posted January 26, 2018 by Premier Disability Services, LLC®

Checking for cardio health issues

American Heart Month begins in February. Heart conditions are among the leading causes of disability in the United States. Certain impairments are considered severe enough to warrant a finding of disability based solely on your condition. These are Social Security’s “Adult Listings” for disability. The most common Listings for heart conditions are:

  • Aneurysm of the Aorta or Major Branches. Regardless of the cause, you will be considered disabled if appropriate medical imaging confirms an aneurysm of the aorta or any major branch.
  • Chronic heart failure. To qualify for disability benefits, your condition must have systolic or diastolic heart failure. Additionally, your heart conditions must fall within given parameters while it is stable. Additionally, you must meet one of the following conditions: Poor performance on an exercise tolerance test, two or more occurrences of heart failure within one year (must have fluid retention and require hospitalization), or symptoms which would limit your ability to work and which would suggest that an exercise test would present a danger to you.
  • Chronic Venous Insufficiency. You will be considered disabled if you have an obstruction and meet one or more of the following: brawny edema which involves 2/3 or more of your leg from the knee to the ankle or 1/3 from your ankle to your hip OR persistent or recurrent ulcerations which fail to heal after being treated for three months.
  • Heart Transplant. You will automatically be considered disabled for at least one year after a heart transplant.
  • Ischemic Heart Disease. To qualify for disability benefits, you must meet one or more of the following: Coronary artery disease (this requires an angiography, medical imaging, and either an exercise test or medical documentation showing why an exercise test would be too dangerous to your health), three distinct ischemic episodes, with each of them needing revasucularization (or in which revascularization is not possible), or an exercise test which shows that you fall within the SSA’s guidelines for complete disability.
  • Peripheral Artery Disease (PAD). Must be shown by medical imaging and fall within the SSA’s guidelines for your blood pressure.
  • Recurrent Arrhythmia. To qualify for disability benefits based on recurring arrhythmias, the medical evidence must show that the condition is not reversible and that it results in near syncope or syncope.
  • Symptomatic Congenital Heart Disease. For symptomatic congenital heart disease, the SSA considers evidence from medical imaging or a heart catheter. They will look to see whether your hematocrit levels and O2 saturation meet with their criteria. You may also qualify if you have right to left shunting or if your systolic pressure is significantly elevated (70% of systemic or higher).

Even if your heart condition does not meet one of the listings above, you may still qualify for disability benefits if your impairments have (or are expected to) put you out of work for one year or longer. The Social Security Administration will consider whether your conditions prevent you from returning to your past work or any other work available in the regional or national economy.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

Adult Listings for cardiovascular impairments: SSA.gov/disability/professionals/bluebook/4.00-Cardio

SSI Expedited Payments

Posted January 19, 2018 by Premier Disability Services, LLC®

Expedited SSS Payments

The Supplemental Security Income (SSI) program provides monthly income to individuals who are low income and do not have the requisite working credits for Title II Social Security Disability Insurance benefits. The Social Security Administration (SSA) can start payments more quickly than usual in four different types of situations:

1.Presumptive Disability (PD) or Presumptive Blindness (PB) payments.
If your claim is for SSI benefits for disability or blindness, the SSA may make PD or PB payments for up to 6 months while you are waiting for the Disability Determination Services (DDS) to make a final decision. The decision to grant PD or PB payments is based on the severity of your condition and the likelihood that your claim will be ultimately approved, and is not based on your financial need. If you are later denied SSI benefits, you do not have to repay your PD or PB payments; however, if you received an overpayment for other reasons then you may be asked to repay some of the PD or PB payments.

2.Emergency Advance Payments.
The SSA may be able to make an emergency advance payment to new applicants who face a financial emergency (meaning you need money right away due to a threat to health or safety, such as not enough money for food, clothing, shelter or medical care) and who are due SSI benefits that are delayed or not received. The SSA can only pay one such advance payment. The maximum emergency advance payment you may receive is the smallest of: the SSI Federal benefit rate (plus any federally administered State supplement); the total amount of the benefits due; or the amount requested for the financial emergency. These payments are later recovered when the SSA subtracts your emergency advance from the payments already due to you. If you are not due past payments, the amount is subtracted form your current monthly benefits in up to 6 monthly installments.

3.Immediate Payments.
The SSA may be able to make an immediate payment to new applicants and those already receiving SSI whose benefits are delayed or not received and who face a financial emergency (see above). The immediate payment cannot be higher than $999.00. Immediate payments are entirely discretionary on the part of the SSA and you do not have formal appeal rights if the SSA determines you are not eligible for an immediate payment. Immediate payments are later subtracted from the first regular payment due to you.

4.Expedited Reinstatement cases.
If your benefits ended because you worked and had earnings, you can request to have your benefits started again without having to complete a new application. This process is called “expedited reinstatement”. You can request that your benefits start again if you: stopped receiving benefits because of earnings from work; are unable to engage in substantial gainful activity because of an impairment(s) that is the same as or related to the impairment(s) that allowed you to get benefits earlier; and make the request within 5 years from the month your benefits ended.

The SSA can give you provisional benefits for up to 6 months while they determine whether you can get benefits again. These benefits include Federal payments and Medicaid coverage. If the SSA decides that you cannot get benefits again, they usually will not ask you to repay the provisional benefits.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

Source: SSA.gov/ssi/text-expedite-ussi.htm

By: Joyce Trudeau of Premier Disability Services, LLC®

Social Security Disability with End-Stage Renal Disease

Posted January 12, 2018 by Premier Disability Services, LLC®

End Stage Renal Disease

End Stage Renal Disease (ESRD), or kidney failure, is an irreversible condition most often caused by Chronic Kidney Disease (CKD), though it can occur suddenly or from other disorders. The National Institutes of Health estimates that over 26 million people have CKD, and many don’t realize until the damage to the kidneys is severe. According to the latest U.S. Renal Data System Annual Report, ESRD affects over 660,000 Americans of all ages.

The United States Renal Data System also found that Medicare spent over $500 billion on kidney disease, making it one of the most expensive disorders. On ESRD alone, Medicare spends $32 billion annually, along with an estimated additional $15 billion for non-Medicare patients.

Because ESRD puts a whole organ out of commission, the treatments are very costly. Most of the costs are from inpatient and outpatient medical care. Individuals waiting for a kidney transplant must often undergo dialysis. The National Kidney Foundation found that dialysis costs $83,000 each year for the average patient. When a kidney becomes available, the transplant will cost over $30,000.

Because the condition requires so much time at the hospital, ESRD is a leading cause of lost productivity. Dialysis requires three days a week for about four hours, which puts a toll on those trying to work, both on their physical abilities and available time.

The Social Security Administration (SSA) has several Adult Listings regarding CKD and ESRD. If you are out of work or earning less than SSA’s current substantial gainful activity amount, and if you meet or equal one of these listings, you will be found disabled. However, even if your CKD does not meet or equal any of the listings, you can be approved another way. The SSA may also award benefits based on a medical-vocational allowance.

To determine whether or not you can work, the SSA will determine your maximum Residual Functioning Capacity (RFC). The examiner takes into account your limitations, education level, and work history to first put you in a category of work (sedentary, light, medium, heavy, or very heavy), and then find jobs you’re qualified for with your work history. If the SSA can’t find a job you can do or decides you can’t even do sedentary work, you may be approved for benefits.

ESRD is a permanent and very debilitating condition, so it can cause many limitations that would keep you out of work. The National Kidney Foundation reported that CKD patients had an average of 10 doctors’ visits a year, second to only cancer. Additionally, dialysis patients need to spend at least 12 hours a week in the hospital for their necessary treatments. Fatigue, mental confusion, sleep problems, and chest pain can make normal tasks hard to complete. Bone pain, swelling of the lower extremities, and impaired motor skills can make it hard to walk, stand, and perform fine movements.

If you or someone you know is unable to work due to a medical condition, please contact us for a free case evaluation.

CKD Listings: SSA.gov/disability/professionals/bluebook/6.00-Genitourinary-Adult
SSA Publication on ESRD: SSA.gov/pubs/EN-64-107

By: Joyce Trudeau of Premier Disability Services, LLC®